Objective: There is a need for natural history chronic fatigue syndrome (CFS) studies from random, community-based, multi-ethnic populations. [That is, not cases selected from a population who had consulted and been diagnosed by doctors, and so not a group ‘biased’ toward 'help-seeking behavior'.]
Design: The present study examined the course of CFS from Wave 1 [1995-1997] to Wave 2 [the same group about 10 years later], which spanned a 10-year period of time, and assessed whether socio-environmental and symptomatology factors were associated with CFS status over the 10-year period.

Results:

• There was relative stability over time on critical measures of disability, fatigue, support, optimism and coping.

• One cardinal symptom of CFS, post-exertional malaise, best differentiated the CFS group from the others.

• By Wave 2, of the original group of 32 individuals diagnosed with CFS, 4 had died, and 24 were found and agreed to be re-evaluated, and of this group:

- 16 continued to have CFS,

- 5 developed exclusionary illnesses [that may account for or confuse cause of symptoms, such as chronic hepatitis C, hypothyroidism or diabetes, at least until adequately treated]